Intracardiac flow pattern in mitral regurgitation studied with combined use of the ultrasonic pulsed doppler technique and cross-sectional echocardiography

Abstract

Thirty patients with mitral regurgitation confirmed by left ventriculography were studied from a transcutaneous approach with combined use of the ultrasonic pulsed Doppler technique and cross-sectional echocardiography. The location of the abnormal Doppler signals was revealed with cross-sectional echocardiography, displayed in two dimensional images. Abnormal Doppler signals, never detected in healthy subjects, were recorded during systole at the mitral area and in the left atrial cavity in patients with mitral regurgitation. In the left atrial cavity, these signals were detected in 11 patients. They were either bidirectional or unidirectional and of a wide velocity range. The area in which these signals were detected was mapped on the cross-sectional echocardiogram, and the map was considered to show the main direction and distribution of regurgitant flow from the mitral ostium into the left atrial cavity. The main direction of the regurgitant flow determined with this method closely coincided with that revealed by angiocardiography. At the mitral area, abnormal Doppler signals were detected in 28 patients. These signals were powerful, bidirectional and of a wide range of velocity. It is believed that these signals indicate not only the mitral regurgitant flow, but also the vibration of the mitral valve. Thus, the combined use of the ultrasonic pulsed Doppler technique and cross-sectional echocardiography is advantageous for the transcutaneous detection and analysis of regurgitant flow in mitral regurgitation.